What Are Migraine Headaches?
Migraines are intense, recurring headaches that can significantly disrupt a child's daily life. More than just a "bad headache," migraines are a neurological condition involving changes in brain activity, blood flow, and nerve signaling. They're characterized by moderate to severe throbbing pain, often accompanied by nausea, vomiting, and sensitivity to light and sound.
Migraines are more common in children than many people realize. About 10% of school-age children and up to 28% of teenagers experience migraines. While they can't be cured, they can be effectively managed with proper treatment, lifestyle modifications, and trigger avoidance.
📌 Important Note: Migraines in children often present differently than in adults. They may be shorter in duration, affect both sides of the head, and include more prominent stomach symptoms.
Symptoms of Migraine in Children
During a Migraine Attack:
🔴 Pain Characteristics
- • Moderate to severe intensity
- • Throbbing or pulsating quality
- • Often bilateral (both sides) in children
- • May shift to one side in older children
- • Worsens with physical activity
🤢 Gastrointestinal Symptoms
- • Nausea (very common)
- • Vomiting
- • Loss of appetite
- • Abdominal pain
💡 Sensory Sensitivity
- • Light sensitivity (photophobia)
- • Sound sensitivity (phonophobia)
- • Smell sensitivity
- • Prefers dark, quiet room
😰 Other Symptoms
- • Pale appearance
- • Dark circles under eyes
- • Fatigue
- • Dizziness
- • Irritability
Before Migraine (Prodrome - Hours to Days Before):
- • Mood changes (irritability, sadness, euphoria)
- • Food cravings
- • Neck stiffness
- • Increased thirst
- • Frequent yawning
- • Constipation
Aura (20-30% of Children - Before Pain Starts):
- • Visual disturbances (zigzag lines, flashing lights, blind spots)
- • Tingling or numbness in face or limbs
- • Difficulty speaking
- • Usually lasts 15-30 minutes
- • Fully reversible
After Migraine (Postdrome):
- • Exhaustion or fatigue
- • Difficulty concentrating
- • Weakness
- • May last 24 hours
- • Some children feel euphoric after migraine resolves
Common Migraine Triggers
Identifying and avoiding triggers can significantly reduce migraine frequency:
🍫 Food Triggers
- • Aged cheeses
- • Chocolate
- • Processed meats (hot dogs, deli meat)
- • MSG (monosodium glutamate)
- • Artificial sweeteners
- • Caffeine (or withdrawal from it)
😴 Sleep Issues
- • Too little sleep
- • Too much sleep
- • Irregular sleep schedule
- • Poor sleep quality
😰 Stress & Emotions
- • School stress
- • Anxiety or worry
- • Excitement
- • Let-down after stress (weekend migraines)
🌦️ Environmental
- • Weather changes
- • Bright or flickering lights
- • Strong odors
- • Loud noises
📱 Screen Time
- • Excessive device use
- • Eye strain
- • Blue light exposure
- • Poor posture while using screens
🎭 Physical Factors
- • Skipping meals
- • Dehydration
- • Intense physical exertion
- • Hormonal changes (puberty)
Treatment Options for Pediatric Migraines
Acute Treatment (During Attack)
💊 Medications
- • Ibuprofen or acetaminophen: First-line for children, most effective when taken early
- • Prescription migraine medications: Triptans (for children 6+ or adolescents) if OTC meds don't work
- • Anti-nausea medication: If vomiting is prominent
- • Take at first sign of migraine for best results
🌙 Rest & Environment
- • Dark, quiet room
- • Cool compress on forehead or back of neck
- • Sleep if possible (often most effective)
- • Minimize sensory stimulation
Preventive Treatment (For Frequent Migraines)
💊 Daily Medications
For children with frequent migraines (4+ per month), preventive medication may be considered:
- • Certain blood pressure medications
- • Antidepressants (low dose)
- • Anti-seizure medications
- • Supplements (magnesium, riboflavin, CoQ10)
🧘 Behavioral Approaches
- • Biofeedback training
- • Cognitive behavioral therapy (CBT)
- • Relaxation techniques
- • Stress management training
Lifestyle Strategies to Prevent Migraines
😴 Regular Sleep Schedule
- ✓ Same bedtime and wake time every day
- ✓ Even on weekends!
- ✓ Age-appropriate sleep duration
- ✓ Relaxing bedtime routine
- ✓ Dark, quiet, cool bedroom
🍽️ Regular Meals
- ✓ Never skip meals, especially breakfast
- ✓ Eat at consistent times
- ✓ Healthy snacks between meals
- ✓ Identify and avoid trigger foods
- ✓ Balanced, nutritious diet
💧 Stay Hydrated
- ✓ Drink water throughout the day
- ✓ Carry water bottle to school
- ✓ Limit caffeinated beverages
- ✓ Increase fluids in hot weather
- ✓ Don't wait until thirsty to drink
🏃 Regular Exercise
- ✓ Daily physical activity
- ✓ Helps reduce stress
- ✓ Improves sleep quality
- ✓ Warm up and cool down properly
- ✓ Avoid sudden intense exertion
😌 Stress Management
- ✓ Teach relaxation techniques
- ✓ Address school or social pressures
- ✓ Allow downtime
- ✓ Balance activities and rest
- ✓ Open communication about feelings
📝 Keep Migraine Diary
- ✓ Track when migraines occur
- ✓ Note potential triggers
- ✓ Record what helps
- ✓ Monitor patterns
- ✓ Share with doctor
⚠️ When to Seek Medical Care
Seek Immediate Care If:
- • Sudden, severe "thunderclap" headache
- • Headache with fever and stiff neck
- • Headache after head injury
- • Confusion, slurred speech, or weakness
- • Vision loss or double vision
- • Severe vomiting with dehydration
- • Worst headache child has ever had
Call Doctor If:
- • Migraines occurring more than once a week
- • Headaches interfering with school or activities
- • Pattern of headaches changing
- • Over-the-counter medications not helping
- • Child waking from sleep with headaches
- • Neurological symptoms during aura lasting more than an hour
Frequently Asked Questions
Q: Can young children get migraines?
Yes! While less common, even toddlers and preschoolers can experience migraines. They may not be able to describe the pain well, but signs include crying, holding their head, seeking dark quiet places, vomiting, and appearing pale or unwell.
Q: Will my child outgrow migraines?
Some children do see improvement or complete resolution of migraines after puberty, but others continue to experience them into adulthood. However, learning good management strategies during childhood helps minimize their impact long-term.
Q: Should my child see a neurologist?
Your pediatrician can manage most childhood migraines. Referral to a pediatric neurologist may be recommended for very frequent migraines, those not responding to treatment, migraines with complicated aura, or when specialized testing is needed.
Q: Can children take the same migraine medications as adults?
Some, but not all. Ibuprofen and acetaminophen are safe and effective for children. Some prescription migraine medications (triptans) are approved for children and adolescents, but dosing and specific medications differ from adults. Always use medications specifically prescribed for your child.
⚠️ Medical Disclaimer
This article provides general information about migraine headaches in children and is not intended to replace professional medical advice, diagnosis, or treatment. If your child experiences severe or frequent headaches, consult with a healthcare provider for proper evaluation and personalized treatment. Seek immediate medical attention for sudden, severe headaches or headaches with concerning symptoms.